WAG 23-08-04-e: How to Submit Clearances or TPL Segments of MMIS

Reopening Cases - Open TPL

(FCRC) Enter the 3-digit TPL code on AIS if the person(s) still has the TPL coverage (i.e., 99/99/99 appears as the lapse date).

Enter 000 or the code for a new TPL resource, if the TPL resource is no longer available.

(FRC) Sends BOC the copy of the clearance indicating that the TPL resource is still available or has lapsed, as appropriate. Includes any changes or corrections to TPL information. The clearance replaces Form
1442/1442CF.

(BOC) Updates the TPL segment of MMIS and enters the 4th digit (level of coverage) code in Item 79 of Form 552.

Reopening Cases - Closed TPL

If the person(s) no longer have access to the TPL resource, no action is needed if the TPL lapse date is correct. If the lapse date is not correct:

(FCRC) Indicate the correct date on the clearance.

(FRC) Sends BOC copy of the corrected clearance.

Reopening Case - Partial TPL Segment

A partial TPL segment appears when the FCRC previously entered a TPL code in Item 79 and Form 1442/1442CF has not been processed by BOC.

A partial segment shows a date in the "RECPT" date field and zeroes in the "VALID, EFF" and "LAPSE" date fields.

(FCRC) Submit a copy of the original Form 1442/1442CF with any changes, if the resource is/was available.

(FCRC) Complete the AIS screens and submit Form 1442CF if a copy of the original Form 1442/1442CF is not available.

If the TPL code was previously entered in error (TPL was never available):

(FRC) Sends BOC a copy of the clearance asking that the partial segment be deleted and the reason (such as the code was entered in error).

Reopening - New TPL

After reviewing the information on the clearance, report TPL on AIS and submit Form 1442CF when the client reports:

a new job with health insurance coverage,

the same job with a different health plan,

other TPL not previously reported, or

the same TPL previously reported is still available but appears on the clearance as closed.

Restoring Assistance - TA 12/TAR 98

When restoring assistance using Type Action (TA) 12 and Type Action Reason (TAR) 98, the system reactivates all information exactly as it appeared on the cancellation Form 552, including the TPL resource code in Item 79. When using TA
12/TAR 98, it is not necessary to send further information to the TPL unit.

Before restoring assistance using a TAR other than 98:

(FCRC) Review the TPL segment of MMIS for all persons in the pending application with a TPL code in Item 79 of the most recent Form 552.

Access PF8 and make an entry in the TPL field to view the TPL segment.

(FCRC) Report the same TPL and changes for each affected client:

on a copy of the TPL segment printed from the MMIS inquiry, or

on Form 1442. Complete a new Form 1442 when the client reports:

a new job with health insurance coverage,

the same job with a different health plan,

other TPL not previously reported, or

the same TPL previously reported is still available but appears on the clearance as closed.

Reapplications Denied

New or corrected TPL information does not need to be reported to BOC for reapplications that are denied unless the information applies to a period of previous medical eligibility. For example, if TPL is identified
during the application process that was available during a period of previous eligibility and the TPL does not appear on the clearance (or the TPL segment of MMIS) as being in effect for that period, complete Form 1442 to report the TPL to BOC.